Background Rheumatoid Arthritis (RA) is an inflammatory and systemic disease. Cardiac involvement during the course of the disease is increase with the RA disease activity. All the cytokines that are involved in arthritic lesions also play an important role in extra-arthritic lesions. Interleukin-6 (IL-6) is a pleiotropic cytokine responsible for many different processes including the regulation of cell growth, apoptosis, differentiation, and survival in various cell types and organs, including the heart. Increased left ventricular mass is defined as Left Ventricular Hypertrophy (LVH). Assessment of LV mass could be done with echocardiography. LHV is an independent prognostic factor of cardiovascular morbidity and mortality.
Objectives Assessment of IL-6 role in LVH in patient with rheumatoid arthritis.
Methods We included in the study 24 patient (16 female, 8 male) diagnosed with RA but did not safer from Arterial Hypertension. All patient were assessed for weight and height. We measured the plasmatic level of RF, CRP, anti-CCP, IL-6 and also assessed the disease activity according to DAS 28. All patient underwent echocardiography 2D color Doppler to assess LV mass index.
Results The group included in the study serial percentage of RF results 27±5.4UI/mL (<20.0 UI/mL); CRP serial level resulted 9.7±5.0 mg/dl (<5.0mg/dl); anti-CCP IgG resulted positive >500 UI/mL (0.1 – 25 UI/mL) in 19 patient (79.2%), negative <7.0 UI/mL (0.1 – 25 UI/mL) in 5 pacient (20.8%); plasmatic percentage e IL-6 resulted increased 25±6.5 pg/mL (<4.0 pg/mL). Disease activity measured according to DAS 28 in the group that we included in the study resulted >5.3. Mass index of LV measured with echocardiography 2D color Doppler resulted female 121±6.8g/m2 (43-95g/m2) and for men 143±7.5g/m2 (49-115g/m2). The value of CRP/IL-6 in the group included in the study resulted 0.36±0.5. The date gives us a correlation between plasmatic level of IL-6 with RF, anti-CCP, CRP and disease activity assessed according to DAS 28 (p<0.05). Increase plasmatic level of IL-6 correlate with increase mass index of the LV in women and men (P<0.01). Patients which has increase ratio PCR/IL-6 ≥0.36 have an increase mass index of LV.
Conclusions IL-6 play an important role in the activity of RA. Patient with increase plasmatic level of IL-6 and increase ratio CRP/IL-6 should undergo periodic echocardiography for the assessment of LV mass index. IL-6 is a risk factor for the development of LVH, which makes it a prognostic factor for the assessment of cardiac involvement in patient with RA.
Disclosure of Interest None declared
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